Family-paid caregivers in hospital health care in China.

AIM: The aims of this study were to identify the attitudes and perceptions of nurses towards family-paid caregivers, to examine the roles of caregivers in hospital bedside nursing care and to describe the supervision of family-paid caregivers by nurses. BACKGROUND: The inadequacy of nurse staffing and the Chinese tradition emphasising family responsibility have established family-paid caregivers as an important workforce for inpatient bedside nursing care in China. DESIGN: This was a descriptive study combining qualitative interviews with a quantitative cross-sectional questionnaire survey. METHODS: Six nurses were interviewed and 209 family-paid caregivers were surveyed. RESULTS: According to the respondents, patients relied on the caregivers to receive assistance and care during hospitalization and family-paid caregivers were involved in most of the bedside nursing care. CONCLUSIONS: The heavy workload of nurses and staffing inadequacy have led to a severe need for caregivers to provide bedside nursing care within hospitals in China. The roles of family-paid caregivers need to be defined and closely monitored. IMPLICATIONS FOR NURSING MANAGEMENT: Proper management of the caregivers should be strengthened and the hospital nursing workforce encouraged to take over bedside nursing care as essential strategies for improving nursing care quality and the patients' satisfaction with the hospitals.

Status of nurse staffing and nursing care delivery in Pudong, Shanghai.

Abstract Aim To evaluate nurse staffing levels and nursing care delivery in adult general medical or surgical wards of hospitals in the Pudong district of Shanghai, China. Background Rapid economic development and improved Chinese living standards have spurred increased demands for high quality health care. Thus, the quality of nursing services has become a focus of attention. Design A cross-sectional, descriptive design was used for the study. Methods We used an anonymous survey to collect data from 1614 nurses from 98 wards in seven general hospitals in Pudong, Shanghai. Results During day shifts, the nurse-to-patient ratios were >1:10. However, these ratios were much higher during evening and night shifts. The clinical front-line nursing workforce primarily consisted of nurses with junior college degrees that had limited working experience. Junior nurses with different educational backgrounds, professional levels, and work experiences were assigned almost similar nursing care work as senior nurses. Conclusions In the surveyed hospitals in the Pudong district, nurse staffing levels and skill mix may be inadequate to meet the increasing demands of patient care. The clinical nursing workforce needs to be strengthened and used effectively to enhance the quality and safety of patient care. Relevance to clinical practice We should focus on the quantity and quality of the nursing workforce, as well as nursing skill utilization.